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. 1992 Jan;67(1 Spec No):53–56. doi: 10.1136/adc.67.1_spec_no.53

Enterobacteriaceae and neonatal necrotising enterocolitis.

M R Millar 1, P MacKay 1, M Levene 1, V Langdale 1, C Martin 1
PMCID: PMC1590331  PMID: 1536588

Abstract

A comparative study of bowel colonisation and incidence of necrotising enterocolitis in neonates admitted to an intensive care unit is reported. Neonates of less than 33 weeks gestational age requiring mechanical ventilation for respiratory distress syndrome were randomised during the first week of life to receive either vancomycin and aztreonam or vancomycin and gentamicin for episodes of suspected sepsis after the first week of life. A higher proportion of neonates who received vancomycin and gentamicin had faecal colonisation with enterobacteriaceae at the end of the second, third, and fourth weeks of life. Treatment with vancomycin and aztreonam was associated with a rapid quantitative reduction in faecal colonisation with enterobacteriaceae, whereas there was no quantitative reduction in colonisation with enterobacteriaceae associated with treatment with vancomycin and gentamicin. There were no differences between the two groups in faecal colonisation with anaerobes, Enterococcus sp, Staphylococcus sp, or yeasts. Six (14.6%) of 41 who received vancomycin and gentamicin compared with 0 of 40 who received vancomycin and aztreonam subsequently developed necrotising enterocolitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bennet R., Eriksson M., Nord C. E., Zetterström R. Fecal bacterial microflora of newborn infants during intensive care management and treatment with five antibiotic regimens. Pediatr Infect Dis. 1986 Sep-Oct;5(5):533–539. doi: 10.1097/00006454-198609000-00009. [DOI] [PubMed] [Google Scholar]
  2. Boyle R., Nelson J. S., Stonestreet B. S., Peter G., Oh W. Alterations in stool flora resulting from oral kanamycin prophylaxis of necrotizing enterocolitis. J Pediatr. 1978 Nov;93(5):857–861. doi: 10.1016/s0022-3476(78)81101-9. [DOI] [PubMed] [Google Scholar]
  3. Carbonaro C. A., Clark D. A., Elseviers D. A bacterial pathogenicity determinant associated with necrotizing enterocolitis. Microb Pathog. 1988 Dec;5(6):427–436. doi: 10.1016/0882-4010(88)90004-6. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Egan E. A., Mantilla G., Nelson R. M., Eitzman D. V. A prospective controlled trial of oral kanamycin in the prevention of neonatal necrotizing enterocolitis. J Pediatr. 1976 Sep;89(3):467–470. doi: 10.1016/s0022-3476(76)80553-7. [DOI] [PubMed] [Google Scholar]
  5. Grylack L. J., Scanlon J. W. Oral gentamicin therapy in the prevention of neonatal necrotizing enterocolitis. A controlled double-blind trial. Am J Dis Child. 1978 Dec;132(12):1192–1194. doi: 10.1001/archpedi.1978.02120370040010. [DOI] [PubMed] [Google Scholar]
  6. Hammerschlag M. R., Klein J. O., Herschel M., Chen F. C., Fermin R. Patterns of use of antibiotics in two newborn nurseries. N Engl J Med. 1977 Jun 2;296(22):1268–1269. doi: 10.1056/NEJM197706022962206. [DOI] [PubMed] [Google Scholar]
  7. Hoy C., Millar M. R., MacKay P., Godwin P. G., Langdale V., Levene M. I. Quantitative changes in faecal microflora preceding necrotising enterocolitis in premature neonates. Arch Dis Child. 1990 Oct;65(10 Spec No):1057–1059. doi: 10.1136/adc.65.10_spec_no.1057. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. LeFrock J. L., Smith B. R., Chandrasekar P., Rolston K. V., Molavi A., Kannangara W. Efficacy and safety of aztreonam in the treatment of serious gram-negative bacterial infections. Arch Intern Med. 1987 Feb;147(2):325–328. [PubMed] [Google Scholar]
  9. Modi N., Damjanovic V., Cooke R. W. Outbreak of cephalosporin resistant Enterobacter cloacae infection in a neonatal intensive care unit. Arch Dis Child. 1987 Feb;62(2):148–151. doi: 10.1136/adc.62.2.148. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Speer M. E., Taber L. H., Yow M. D., Rudolph A. J., Urteaga J., Waller S. Fulminant neonatal sepsis and necrotizing enterocolitis associated with a "nonenteropathogenic" strain of Escherichia coli. J Pediatr. 1976 Jul;89(1):91–95. doi: 10.1016/s0022-3476(76)80939-0. [DOI] [PubMed] [Google Scholar]
  11. Umaña M. A., Odio C. M., Castro E., Salas J. L., McCracken G. H., Jr Evaluation of aztreonam and ampicillin vs. amikacin and ampicillin for treatment of neonatal bacterial infections. Pediatr Infect Dis J. 1990 Mar;9(3):175–180. doi: 10.1097/00006454-199003000-00006. [DOI] [PubMed] [Google Scholar]
  12. Westra-Meijer C. M., Degener J. E., Dzoljic-Danilovic G., Michel M. F., Mettau J. W. Quantitative study of the aerobic and anaerobic faecal flora in neonatal necrotising enterocolitis. Arch Dis Child. 1983 Jul;58(7):523–528. doi: 10.1136/adc.58.7.523. [DOI] [PMC free article] [PubMed] [Google Scholar]

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